TY  - CHAP
M1  - Book, Section
TI  - Spinal Cord and Spine
A1  - Stahel, Philip F.
A1  - Dorenkamp, Benjamin C.
A1  - Janssen, Michael E.
A2  - Feliciano, David V.
A2  - Mattox, Kenneth L.
A2  - Moore, Ernest E.
Y1  - 2020
N1  - 
T2  - Trauma, 9e
AB  - KEY  POINTSThe  presence  of  an  unstable  spinal  injury  is  presumed  in  all  trauma  patients  until  proven  otherwise.Complete  and  thorough  spinal  evaluation  and  neurologic  examination  are  mandatory  in  all  critically  injured  patients.Strict  log-roll  precautions  and  cervical  rigid-collar  immobilization  should  be  continued  until  unstable  injuries  are  ruled  out  or  identified  and  managed  by  early  proactive  surgical  treatment  protocols.Computed  tomography  is  the  standard  initial  diagnostic  trauma  workup  in  patients  requiring  imaging.  Magnetic  resonance  imaging  is  indicated  on  a  case-by-case  basis  after  formal  spine  surgery  consultation.An  accurate  classification  of  spine  injuries  using  validated  classification  systems  facilitates  surgical  decision  making  and  serves  as  a  basis  to  guide  treatment.Early  mobilization  of  critically  injured  patients  with  spinal  injuries  is  essential.  This  requires  either  spinal  clearance  or  spinal  stabilization  by  surgical  means.Spinal  clearance  should  be  provided  within  24  hours  of  admission  to  minimize  the  risk  of  preventable  immobilization-related  complications.A  standardized  spine  damage  control  protocol  allows  stabilization  of  unstable  thoracic  and  lumbar  spine  fractures  within  24  hours  and  subsequent  mobilization  of  patients  without  restrictions.Unstable  cervical  spine  injuries  benefit  from  halo-vest  application  or  Gardner-Wells  tong  traction  until  definitive  surgical  fixation  is  performed.The  use  of  steroids  is  considered  obsolete  in  the  management  of  acute  traumatic  spinal  cord  injury.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/16
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1175133484
ER  -